Health Minister Gaétan Barrette suggested on Monday that some doctors at the McGill University Health Centre might be “putting pressure on patients” to keep coming back to the MUHC when equally good care is available to them closer to where they live.

Barrette also chastised the MUHC for exceeding its budget year after year, noting that the Centre hospitalier de l’Université de Montréal (CHUM) doesn’t do so. The minister made the comments in response to an article in the Montreal Gazette that reported the provincial government is faulting the MUHC for taking on too many cancer and emergency-room patients, and is refusing to fund what it calls “volume overruns.”

The article observed that the MUHC is facing a shortfall of $10 million arising from the “volume overruns,” in addition to a planned budget cut of $28.1 million. Barrette did not dispute those figures, but argued the MUHC has failed to stick to a 2007 clinical plan that set those volumes.

And Barrette accused a Gazette reporter of scaremongering, suggesting the reporter insinuated in a question posed to him at a Monday morning news conference that patients might die. In fact, the reporter asked Barrette what should the minister tell those cancer patients who choose to go to the MUHC’s Cedars Cancer Centre to try to save their lives.

“In Quebec, we have planned our network in such a way that there will be access to appropriate care everywhere in the province, and this is the case in cancer,” Barrette responded in English. “But we want care to be provided closer to homes. And that’s what we did. If doctors do not want to move their practices, it is their choice. It is (these doctors) who maybe are putting pressure on patients.

“And I disagree totally with you,” he told the reporter, “and I’m quite surprised and disappointed, when you suggest that people may die because of that. That is a wrong statement on your part.”

Patient-rights advocate Paul Brunet, of the Conseil pour la protection des malades, said patients with advanced cancer deserve the best chemotherapy, radiotherapy and clinical trials — services that are more available at super-specialized clinics like the Cedars Cancer Centre than in some outlying regions.

“The MUHC is supposed to be a world-renowned tertiary- and quaternary-care centre,” Brunet said. “Why can’t all Quebecers who paid for that very costly hospital go there from wherever they come?”

Brunet argued that health-care dollars should follow the patient, not the other way around: “The minister is doing exactly the opposite by being pissed off at doctors who are welcoming patients wherever they come from.”

And Brunet contended the government’s insistence that the MUHC advise patients to seek care closer to where they live is probably in violation of the Canada Health Act, which imposes no restrictions on where one can receive medical attention.

In Quebec City, the Parti Québécois’s health critic denounced Barrette for “penalizing” the MUHC for its efficiency. Diane Lamarre did not address the issue of cancer patients, but spoke about ER volumes soaring at the MUHC’s superhospital in Notre-Dame-de-Grâce since it opened in April 2015.

“I don’t think we have to penalize and blame the MUHC because they receive patients in the emergency,” Lamarre said.

“I know that the MUHC has a lot of good services in the emergency room, and they were penalized maybe because there was not this kind of access somewhere else.”

Lamarre attributed part of the MUHC’s financial problems to the cost-cutting administrative reform that Barrette implemented in 2015. Under the reform — known as Bill 10 — the minister merged hospitals across Quebec under the management of new organizations and cut more than 1,300 managerial positions.

Lamarre said the reform has produced chaos in the health system, including in emergency services.

The MUHC’s 2007 clinical plan was devised under the late Arthur Porter, who served as its executive director at the time, and who was hoping for quick approval to have the $1.3-billion superhospital built. A number of MUHC physicians and managers have since told the Gazette that the nine-year-old clinical plan no longer meets today’s medical reality of Quebec’s aging population.

“At this point in time, that is not the issue,” Barrette said. “The issue is about realizing what has been planned and accepted by (the MUHC). I cannot and I will not subsidize, fund, a hospital that is always over its allocated budget. It is impossible to run a network that way.

“Everybody wants to have more,” he added. “There has to be control over spending and that applies to the MUHC, as it does to any institution in this province.”

The MUHC ended its 2015-2016 fiscal year with a deficit of $41 million. The minister drew several comparisons between the MUHC and CHUM, despite the fact that the CHUM has reported budget deficits in the past.

“How is it that the CHUM is always within its budget?” he asked. “How is that possible? How is it that the MUHC is always over?”

Barrette suggested some MUHC physicians “behaved in a way that they basically said, we’ll see at the end, we’ll win over the minister … Well, it won’t happen. The CHUM, as we speak today, is within their budget.”

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